Tattoo Removal Policy - Prior Approval - Plain Language Summary

Sep 13, 2026

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Tattoo removal requests are considered only after prior approval and clinical evidence. Funding is not approved for cosmetic-only reasons, and treatment is limited to tattoo areas producing an intractable significant allergic reaction; complete removal for cosmetic improvement is not funded. The policy explains eligibility criteria, shared decision-making, and the BRAN framework (benefits, risks, alternatives, do nothing), including expected response differences by tattoo colour and guidance on safer options and when to seek advice.

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Tattoo Removal Policy

Prior Approval

Tattoo Removal Eligibility Criteria

Notes on Funding

BRAN Framework (Benefits, Risks, Alternatives, Do Nothing)

Tattoo Removal – Plain Language Summary

Shared Decision Making (Ask 3 Questions)

Connected Policies

Due Regard

Document Control

Governance

OPCS Procedure Codes

Tattoo Removal Policy Prior Approval Before consideration of referral for management in secondary care, please review advice on the Remedy website ([www.remedy.bnssg.icb.nhs.uk/](www.remedy.bnssg.icb.nhs.uk/)) or consider use of advice and guidance services where available Tattoo Removal Requests for the removal of tattoos may be considered if the following can be clinically evidenced: 􀁸 Where the dye has caused a significant allergic reaction resulting in skin changes and/or two or more episodes of infection AND 􀁸 All alternative treatments to manage the allergic reaction and/or recurrent infections have failed. A copy of the patient’s clinical records should be supplied to evidence these criteria. For more guidance please see [https://remedy.bnssg.icb.nhs.uk](https://remedy.bnssg.icb.nhs.uk) Notes: 1. Funding will not be approved where a patient is looking for tattoo removal due to cosmetic concerns. 2. Funding approval will only be given to treat the areas of the tattoo with an intractable significant allergic reaction. 3. Complete tattoo removal to provide an improved cosmetic outcome is NOT funded. BRAN For any health-related decision, it is important to consider “BRAN” which stands for: 􀁸 Benefits 􀁸 Risks 􀁸 Alternatives 􀁸 Do Nothing Benefits 􀁸 Removal of infection, with associated risks alleviated. Risks 􀁸 Some colours not completely fading – yellow, green and purple ink requires more sessions to fade than black, blue and red. 􀁸 A small chance your skin may become temporarily darker or paler than the surrounding skin. 􀁸 A slight chance of permanent scarring (3 in 100 people develop a scar) Alternatives 􀁸 Over the counter medications: Tylenol and nonsteroidal anti-inflammatory drugs (NSAIDs) . 􀁸 Antihistamine medications: Benadryl, for instance, can reduce symptoms of a minor allergic reaction, such as small, red bumps or a faint rash around the tattoo site. 􀁸 Topical creams: A hypoallergenic, fragrance-free cream can stop the skin from drying out. 􀁸 Keeping the site clean by gently washing with soap and water 􀁸 Covering the tattoo site with a fresh, sterile gauze or bandage 􀁸 Wearing gloves while sleeping to avoid scratching a new tattoo Do Nothing Remember, you always have the option to do nothing. Doing nothing is an equally reasonable option to doing something. Sometimes “not yet” is a good enough answer until you gather more information. Tattoo Removal – Plain Language Summary A tattoo is a mark made by inserting pigment, through a tiny needle, into the skin. People choose to be tattooed for various cosmetic, social or religious reasons. It carries certain health risks and can result in an allergic reaction. Tattoos are intended as permanent, so removing them is difficult. Complete removal is not always possible. Tattoos can be removed by laser, surgical excision or dermabrasion. When using laser, single colour black or red tattoos usually respond well to laser treatment. Other colours do not usually respond as well. Laser treatment is an effective way to break up the ink, thereby allowing it to be absorbed and discarded by your body. This is considered safe and harmless. There are also many brands of skin cover-up available which can be used to cover up and conceal tattoos. Shared Decision Making If a person fulfils the criteria for Tattoo Removal it is important to have a partnership approach between the person and the clinician. Shared Decision Making (SDM) is the meeting of minds of two types of experts: CLINICIAN EXPERT Diagnosis Tests Treatment Prognosis It puts people at the centre of decisions about their own treatment and care and respects what is unique about them. It means that people receiving care and clinicians delivering care can understand what is important to the other person. The person and their clinician may find it helpful to use ‘Ask 3 Questions’: 1. What are my options? (see sections above) 2.

FAQs

What conditions must be met for tattoo removal to be considered?

Requests may be considered when the dye has caused a significant allergic reaction with skin changes and/or two or more infection episodes, and all alternative treatments for the allergic reaction and recurrent infections have failed. Clinical records must be provided to evidence these criteria.

Will funding be approved for cosmetic reasons or complete removal?

Funding is not approved for cosmetic-only concerns. Funding approval is limited to treating tattoo areas with an intractable significant allergic reaction, and complete tattoo removal to improve cosmetic outcome is not funded.

How does BRAN support decisions about tattoo removal?

BRAN guides discussion of benefits, risks, alternatives, and doing nothing. It includes expected differences by tattoo colour for fading and notes risks such as temporary skin colour changes and a small chance of permanent scarring.

Sep 13, 2026

Upload by Violet